Nosocomial pneumonia in the intensive care unit of a Brazilian university hospital: an analysis of the time span from admission to disease onset

Gusmão, Maria Enoy Neves; Dourado, Inês; Fiaccone, Rosimeire Leovigildo

doi:10.1016/j.ajic.2003.11.003

Cited by 13 publications

(7 citation statements)

References 11 publications

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“…In this study the finding of a relationship between diabetes mellitus, usage of steroid, antibiotics and nosocomial infection was in accordance with the literature (17). The finding of a relationship between respiratory deficiency, unconsciousness, intubation, mechanical ventilation and lower respiratory tract infection were found in accordance with the literature [18,19]. …”

Section: Discussionsupporting

confidence: 91%

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Evaluation of nosocomial infections and risk factors in critically ill patients

et al. 2011

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SummaryBackgroundNosocomial infections are one of the most serious complications in intensive care unit patients because they lead to high morbidity, mortality, length of stay and cost. The aim of this study was to determine the nosocomial infections, risk factors, pathogens and the antimicrobial susceptibilities of them in intensive care unit of a university hospital.Material/MethodsThe patients were observed prospectively by the unit-directed active surveillance method based on patient and the laboratory.Results20.1% of the patients developed a total of 40 intensive care unit-acquired infections for a total of 988 patient-days. The infection sites were the lower respiratory tract, urinary tract, bloodstream, wound, and the central nervous system. The respiratory deficiency, diabetes mellitus, usage of steroid and antibiotics were found as the risk factors. The most common pathogens were Enterobacteriaceae, Staphylococcus aureus, Candida species. No vancomycin resistance was determined in Gram positive bacteria. Imipenem and meropenem were found to be the most effective antibiotics to Enterobacteriaceae.ConclusionsHospital infection rate in intensive care unit is not very high. The diabetes mellitus, length of stay, usage of steroids, urinary catheter and central venous catheter were determined as the risk factors by the final logistic regression analysis. These data, which were collected from a newly established intensive care unit of a university hospital, are important in order to predict the infections and the antimicrobial resistance profile that will develop in the future.

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Section: Discussionsupporting

confidence: 91%

“…Urinary catheterization was recognized as the main risk factor for nosocomial infection by Girou et al [20] and mechanical ventilation was recognized as the main risk factor for nosocomial pneumonia by McCusker et al [21] and Gusmào et al [19] in previous studies. Leone et al [22].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of nosocomial infections and risk factors in critically ill patients

et al. 2011

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“…Some studies determined respiratory distress as a risk factor for VAP (11,16). However, some others did not determine any correlation between the diagnosis at admission and development of VAP (15). An important finding of our study is the determination of respiratory distress and poor general condition as the primary diagnosis upon admission as the risk factors for mortality.…”

Section: Discussionmentioning

confidence: 51%

“…Similarly, there is no consensus on the effect of the age of the patients. Some studies reported that age was not a significant factor for VAP development while some others claimed that an old age alone increased the risk of VAP (8,12,14,15). In our study, we determined that the patients that were diagnosed with VAP were elderly patients; however, age was not found as a risk factor for mortality.…”

Section: Discussionmentioning

confidence: 55%

Analysis of epidemiology and risk factors for mortality in ventilator-associated pneumonia attacks in intensive care unit patients

But¹,

Yetkin²,

Kanyılmaz³

et al. 2017

Turk J Med Sci

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This retrospective observational study was conducted at the medical/surgical ICU of Ankara Numune Research and Training Hospital for the period of January 2010 to June 2015. This hospital is a referral hospital and there were Background/aim: The aim of this study was to investigate the epidemiologic characteristics, the causative microorganisms and their antimicrobial susceptibility patterns, and the prognostic risk factors for mortality in critically ill patients with ventilator-associated pneumonia (VAP). Materials and methods:In this retrospective observational study, all the critically ill patients with VAP hospitalized in a medical/surgical intensive care unit (ICU) between January 2010 and June 2015 were evaluated. Patients' demographic features and microbiological data were reviewed.Results: A total of 417 patients were clinically diagnosed with VAP; 51.1% of them were male and the average age was found as 69.9 ± 15.9 years. VAP was detected at approximately 25.0 ± 18.0 days of ICU stay and 17.9 ± 12.6 days after intubation. Acinetobacter baumannii (69.5%) was isolated as the most frequent VAP agent, and the most effective antibiotic was colistin. The crude mortality rate was detected as 39.8% among the patients. The presence of dyspnea at admission, coronary heart disease as a comorbidity, unconsciousness at admission, steroid usage, and prolonged hospital stay were observed as independent risk factors in multivariate analysis (P < 0.01). Conclusion:According to the etiological microorganisms and antimicrobial susceptibility patterns, colistin was found to be the most reliable antibiotic for empirical antimicrobial therapy.

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“…Estudo realizado, em 2006, demonstrou uma frequência de 69% para o foco pulmonar e 23% para o abdominal 17 . Nesse sentido, a aquisição de infecção nestes sítios pode estar relacionada principalmente a elevada microbiota endógena do trato respiratório e digestivo que pode facilitar a infecção em pacientes imunocomprometidos 22,23 . A pneumonia é uma das mais frequentes patologias em pacientes com sepse, visto que o sítio respiratório é uma das principais fontes dos processos infecciosos, fato que está associado a maior frequência do uso de ventilação mecânica e permanência prolongada em UTI, conforme mostrado em nossos dados 5,24,25 .…”

Section: ▄ Resultadosunclassified

Fatores de risco associados ao agravamento de sepse em pacientes em Unidade de Terapia Intensiva

Barros¹,

Maia

Monteiro

2016

Cad. saúde colet.

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Resumo Introdução a sepse é um grave problema de saúde pública e uma das principais causas de morte em Unidade de Terapia Intensiva (UTI). Objetivo este trabalho avaliou o agravamento e a mortalidade de pacientes sepse em UTI, relacionando aos fatores de risco, diferentes etiologias e terapêuticas. Metodologia O estudo foi observacional descritivo, e avaliou os casos de sepse (sepse, sepse severa e choque séptico) no período de janeiro de 2009 a dezembro de 2010. Resultados dos 212 pacientes internados em UTI, 181 apresentaram sepse nas diferentes gravidades, cuja mortalidade por sepse na UTI foi de 63%, principalmente nos pacientes com choque séptico (53%), seguida da sepse grave (8,3%). Além disso, os fatores de risco associados ao agravamento da sepse foram: idade superior que 65 anos, maior tempo médio de internação na UTI, elevada frequência de comorbidades e a utilização de procedimentos invasivos. O maior consumo de antibióticos foi de carbapenêmicos, e as principais cepas multirresistentes isoladas foram MRSA, VRE, P. aeruginosa e A. baumannii resistente a carbapenêmicos. Conclusão este estudo mostrou uma elevada mortalidade por sepse na UTI, principalmente em pacientes com choque séptico com comorbidades, que foram submetidos aos procedimentos invasivos e com maior tempo de internação.

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Nosocomial pneumonia in the intensive care unit of a Brazilian university hospital: an analysis of the time span from admission to disease onset

Cited by 13 publications

References 11 publications

Evaluation of nosocomial infections and risk factors in critically ill patients

Evaluation of nosocomial infections and risk factors in critically ill patients

Analysis of epidemiology and risk factors for mortality in ventilator-associated pneumonia attacks in intensive care unit patients

Fatores de risco associados ao agravamento de sepse em pacientes em Unidade de Terapia Intensiva

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